Family physician views about primary care reform in Ontario: a postal questionnaire

BACKGROUND: Primary care reform initiatives in Ontario are proceeding with little information about the views of practicing family physicians. METHODS: A postal questionnaire was sent to 1200 randomly selected family physicians in Ontario five months after the initial invitation to join the Ontario Family Health Network. It sought information about their practice characteristics, their intention to participate in the Network and their views about the organization and financing of primary care. RESULTS: The response rate was 50.3%. While many family physicians recognize the need for change in the delivery of primary care, the majority (72%) did not expect to join the Ontario Family Health Network by 2004, or by some later date (60%). Nor did they favour capitation or rostering, 2 key elements of the proposed reforms. Physicians who favour capitation were 5.5 times more likely to report that they expected to join the Network by 2004, although these practices comprise 5% of the sample. CONCLUSIONS: The results of this survey, conducted five months after the initial offering of primary care reform agreements to all Ontario physicians, suggest that an 80% enrollment target is unrealistic

Are wildcard events on infrastructure systems opportunities for transformational change?

Infrastructure systems face a number of pressing challenges relating to demographics, environment, finance and governance pressures. Furthermore, infrastructure mediates the way in which everyday lives are conducted; their form and function creating a persistence of unsustainable practice and behaviour that cannot be changed even if change is desired. There is a need to find means by which this obduracy can be broken so that new, more sustainable futures can be planned. This paper develops a methodology, taking concepts from both engineering and social science. Wild cards, or physical disruptions, are used to ‘destructively test’ complex infrastructure systems and the multi-level perspective is used as a framework for analysing the resulting data. This methodology was used to examine a number of case studies, and with focus groups consisting of a range of different infrastructure providers and managers, to gain a better understanding of systems’ sociotechnical characteristics and behaviours. A number of impactful ‘intervention points’ emerged that offered the opportunity to promote radical changes towards configurations of infrastructure systems that provide for ‘less’ physical infrastructure. This paper also examines the utility of wild cards as enablers of transition to these ‘less’ configurations and demonstrates how a ‘wild card scenario’ can be used to co-design infrastructure adaptation from with both infrastructure providers and users

GMOs in animal agriculture: time to consider both costs and benefits in regulatory evaluations

In 2012, genetically engineered (GE) crops were grown by 17.3 million farmers on over 170 million hectares. Over 70% of harvested GE biomass is fed to food producing animals, making them the major consumers of GE crops for the past 15 plus years. Prior to commercialization, GE crops go through an extensive regulatory evaluation. Over one hundred regulatory submissions have shown compositional equivalence, and comparable levels of safety, between GE crops and their conventional counterparts. One component of regulatory compliance is whole GE food/feed animal feeding studies. Both regulatory studies and independent peer-reviewed studies have shown that GE crops can be safely used in animal feed, and rDNA fragments have never been detected in products (e.g. milk, meat, eggs) derived from animals that consumed GE feed. Despite the fact that the scientific weight of evidence from these hundreds of studies have not revealed unique risks associated with GE feed, some groups are calling for more animal feeding studies, including long-term rodent studies and studies in target livestock species for the approval of GE crops. It is an opportune time to review the results of such studies as have been done to date to evaluate the value of the additional information obtained. Requiring long-term and target animal feeding studies would sharply increase regulatory compliance costs and prolong the regulatory process associated with the commercialization of GE crops. Such costs may impede the development of feed crops with enhanced nutritional characteristics and durability, particularly in the local varieties in small and poor developing countries. More generally it is time for regulatory evaluations to more explicitly consider both the reasonable and unique risks and benefits associated with the use of both GE plants and animals in agricultural systems, and weigh them against those associated with existing systems, and those of regulatory inaction. This would represent a shift away from a GE evaluation process that currently focuses only on risk assessment and identifying ever diminishing marginal hazards, to a regulatory approach that more objectively evaluates and communicates the likely impact of approving a new GE plant or animal on agricultural production systems

Partnership in development : Canadian universities and World Food

Examines the extent and nature of university involvement in food system development during the years 1968-1978, and reviews critically the result of these activities in order to identify the kinds of programs that should be concentrated on in the future